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Biomedical subjects

J Fischer

Publications and source records attributed to J Fischer.

At least 271 records · Page 15Linked to original sources
PubMed1993

[An unusual case of a blow-out fracture. Entrance of a bone fragment into the frontal lobe after a ski accident].

Due to a ski accident a 16-year old girl suffered from headache, periorbital hematoma and ptosis of the right eyelid. No penetrating injury could be seen, but in the CT scan a blow-out fracture of the orbital roof and floor was verified. Since there was no evident lesion of the eye muscles, an operative indication could only be a neurosurgical one. Because of the traumatic connection between frontal cerebrum and sinus maxillaris we expected a CSF rhinorrhoea, which could not be confirmed.

Adolescent↗
PubMed1993

Difficulties in the antenatal assessment of neonatal alloimmune thrombocytopenia.

In this paper we present a patient with an initially questionable history of neonatal alloimmune thrombocytopenia (NAT) due to materno-fetal HPA-1a (PLA1) incompatibility. No circulating antibodies were detectable in untreated maternal serum, but an adsorption/elution technique enabled the demonstration of the platelet-specific anti-HPA-1a (anti-PLA1) in maternal serum. Cordocentesis at 35 weeks of gestation revealed a fetal platelet count of 18 x 10(9)/l. Intrauterine platelet transfusion with HPA-1a (PLA1)-negative donor platelets was performed prior to cesarean section.

Antigens, Human Platelet↗
PubMed1993

[Stereotaxic biopsy of brain tumors].

The work re-evaluates the meaning of stereotactic bioptic examination in 50 neurosurgical patients. Bioptic material gained for histologic purposes does not secure always the achievement of the correct histologic diagnosis. The authors critically reevaluate the possibilities of this diagnostic method. They do not consider as adequate to claim multiple expansive processes to be inoperable, respectively as being refractory towards therapy, when the histologic conclusion is lacking. In cases of inconsistency in histologic conclusions from two neuropathologists the further fate of the patient is conditioned by the neuropathologist's stand-point, but also by the clinical experience of the neurosurgeon who overtakes the final responsibility for the patient's further fate. Recently available methods (CT,MR, spectrography) are diagnostically not so precise as to be able to manage without stereotactic biopsy. (Tab. 3, Fig. 5, Ref. 10.).

Biopsy, Needle↗
PubMed1993

[The role of the neurosurgeon in histopathologic diagnosis].

Neurosurgical practice has proved that the establishment of a correct neurohistopathologic diagnosis is sometimes difficult. Inconsistency of diagnoses resulting from unbiased examinations of several neuropathologists is not uncommon. The authors-neurosurgeons-have performed 300 fast neurohistopathologic examinations by means of smear technique. Correct diagnosis was stated in more than 90% of cases. Bioptic examination may represent a contribution in cases where postoperative irradiation is indicated, namely under diagnostically controversial circumstances. The authors re-evaluate the possibilities of utilization of smear technique for the purpose of histopathologic diagnostics performed directly by neurosurgeons. (Tab. 7, Ref. 5.).

Biopsy↗
PubMed1993

[Osteogenetic cells in myositis ossificans].

We have used the lectins Arachis hypogaea (PNA), Canavalia ensiformis (Con A) and Triticum vulgaris (WGA) for the examination of bone forming cells in 8 variously differentiated cases of myositis ossificans. The development of myositis ossificans could be characterized with the appearance of a WGA binding cell population. In this cell population the lectin binding spots may be found in the perinuclear cytoplasm, possibly in the Golgi complex. The lectin binding of the bone forming cells has disappeared in the ripe myositis ossificans. We think that the WGA binding cell population may be equal with the progenitor cells, wandering in form the stroma ot the bone marrow and that the ability of WGA binding may be a characteristic developmental marker of these cells.

Adult↗
PubMed1993

[Incidence of obstructive sleep apnea syndrome in combination with chronic obstructive respiratory tract disease].

Polysomnographic measurements were performed in 210 indoor patients (age mean = 49.7 +/- 8.9 years, Broca mean = 126.0 +/- 20.7% FEV1%p mean = 79.9 +/- 23.9) of a pneumological rehabilitation centre who had a suspicious history or clinical symptoms of obstructive sleep apnoea. 72 had neither an airway obstruction nor a pathological apnoea index. 58 patients only suffered from airway obstruction and 42 had only a pathological apnoea index. In 38 patients, a pathological apnoea index and also airway obstructions were seen. For the last three groups we calculated the mean of the SaO2-values for an 8 hour night time period with and without n-CPAP-therapy. In both groups with only one disease a typical pattern of the SaO2-values during sleep could be demonstrated. The patients with overlap syndrome (SAS + COB) showed a superposition of both single disease SaO2-time courses even with much lower initial SaO2-values. During n-CPAP-therapy in all groups a reduction of the variations of SaO2 induced by sleep pattern and circadian rhythm are evident.

Adult↗
PubMed1993

[Use of acoustic rhinometry for determining segmental airway geometry with nasal positive or negative pressure].

The investigations show an application of nasal acoustic rhinometry for determination of segmental naso- and oropharyngeal airway cross-section during negative or positive pressure breathing. The investigations show in 16 patients with obstructive sleep apnoea (AI = 21.5), that negative pressure produces a segmentally different reduction of naso-oropharyngeal cross-section which is weakly correlated to the Broca index. But the amount of cross-sectional reduction is highly significantly correlated to the apnoea index (r = 0.64). The functional relationship between pressure load of the airways during wakefulness and the severe nature of the disease reveals the possibility of diagnostic use.

Adult↗
PubMed1993

Surgical and postoperative management of two neonates with necrotizing fasciitis.

Two neonates who presented with necrotizing fasciitis (NF) secondary to omphalitis were treated by radical excision of the anterior abdominal wall. Postoperatively, renal failure in both children was managed by continuous arteriovenous hemofiltration (CAVH). One child survived; the other died of sepsis. Serum lactate levels, which were 10 to 15 times the normal levels in both infants postoperatively, decreased rapidly in the survivor, but never approached normal levels in the infant who died. Although the best prospect for survival in neonatal NF remains prompt, radical, surgical excision and is associated with a low threshold for repeat débridement, modern supportive measures (including CAVH) may enhance survival.

Acute Kidney Injury↗
PubMed1993

[Perioperative clinical pathomorphologic evaluation of pararectal lymph node status and its contribution to definitive decision for local excision of rectal cancer].

On the basis of 669 patients with rectal carcinoma, who underwent radical surgery, we evaluated by means of discriminant statistics the prognostic value of 7 factors concerning lymph node involvement. By stratifying for important prognostic factors (level of differentiation, lymphocytic stromal reaction, depth of tumour infiltration) we have revealed 3 different groups: I--no or rare lymph node metastases; II--more frequent metastases but confined to "N1", and III--numerous distant metastases classified as "N2-3". On the basis of these results the final decision for local extirpation of the tumour with curative intention is made easier.

Adenocarcinoma↗
PubMed1993

[Prevalence of obstruction of extrathoracic and intrathoracic airways in patients with arterial hypertension].

The object of this study was to find out the difference between patients with and without arterial hypertension in respect of oxygen desaturation, obesity and obstructive sleep apnoea. 497 men were examined who had chronic diseases of the respiratory passages and whose average age was mean = 45.9 +/- 11.2 years, the Broca index being 109 +/- 17%. 106 men (age mean = 48.6 yrs, Broca index = 118.4, systolic blood pressure according to Riva-Rocci mean = 154.6 mmHg, diastolic 101.4 mmHg) had arterial hypertension. 391 men (age mean = 45.1 yrs, Broca = 107.1, BP/RRsys mean = 130.5 mmHg, BP/RRdia mean = 82.5 mmHg) had normal blood pressure. Another subdivision was effected according to frequency of oxygen desaturations measured according to frequency of oxygen desaturations measured during 8 hrs sleep (SaO2 > 90%, frequency > 80/8 hrs) and the Broca index (> 120%). 31.1% of the hypertensive and 16.6% of the normotensive patients had more than 80 SaO2 drops/8 hrs to below 90%. 44.7% of obese hypertensives and 37.1% of obese normotensives were suspected of suffering from obstructive sleep apnoea. 45 highly suspicious patients were examined by polysomnography. This was the case with 19.8% of the hypertensives and 6.1% of the normotensives. 78.9% of the hypertensives examined via polysomnography because of suspicion of pulse oximetry and/or obesity had in fact an apnoea index > 10, whereas only 41.2% of the normotensives selected according to the same criteria demonstrated this phenomenon. On the whole, patients suffering from arterial hypertension were at markedly higher risk of obstructive sleep apnoea.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Pneumonia associated with Salmonella choleraesuis infection in swine: 99 cases (1987-1990).

Salmonella choleraesuis was isolated in pure or mixed bacterial cultures from 153 swine necropsied between Jan 1, 1987 and Dec 31, 1990. Pneumonia was seen in 99 of 109 swine from which this bacterium was isolated in the absence of other pathogenic bacteria. Pneumonia was seen more frequently than hepatitis, splenomegaly, or colitis. Pleuropneumonia that was grossly indistinguishable from the pleuropneumonia associated with Actinobacillus pleuropneumoniae was seen in 29 of 99 swine from which S choleraesuis was the only bacterium isolated.

Animals↗
PubMed1992

Low-dose (7.5 mg) oral methotrexate for chronic progressive multiple sclerosis. Design of a randomized, placebo-controlled trial with sample size benefits from a composite outcome variable including preliminary data on toxicity.

OBJECTIVE: To present a detailed description of (1) the study design of this ongoing trial, (2) advantages of using a composite outcome variable instead of multiple individual outcome measures, (3) treatment group characteristics at baseline, and (4) observed short-term methotrexate (MTX) toxicity. DESIGN: Randomized, double-masked, placebo-controlled intervention study. SETTING: Referral-based outpatient multidisciplinary multiple sclerosis (MS) clinic. PATIENTS: Participation offered to all clinically definite chronic progressive multiple sclerosis (CPMS) patients attending clinic ages 21 to 60, disease duration > 1 year, Expanded Disability Status Scale (EDSS) score 3.0 to 6.5 (ambulatory with moderate disability). Patients first stratified by EDSS 3.0 to 5.5 and 6.0 to 6.5, then randomized to MTX or placebo treatment. INTERVENTION: Weekly oral low-dose (7.5 mg) MTX or identical-appearing placebo for 2 years followed by a 1-year observation period. MAIN OUTCOME MEASURES: Sample size calculations undertaken prior to enrolling patients based upon a composite outcome variable consisting of designated change in any of the following functional measures: (1) EDSS, (2) Ambulation Index (AI), (3) Box and Block Test (BBT), and (4) 9-Hole Peg Test (9HPT). RESULTS: (1) Treatment group characteristics were comparable at baseline, (2) no patient has been withdrawn for adverse effects or lost to follow-up, (3) no significant short-term MTX toxicity has been observed. CONCLUSIONS: (1) The use of a composite outcome measure in the design of MS clinical trials is a promising alternative to multiple individual outcome measures that are relatively insensitive to detecting clinical change, (2) low-dose oral weekly MTX does not appear to be associated with significant short-term toxicity in CPMS. Conclusions regarding therapeutic efficacy of MTX in MS must await completion of this clinical trial.

Adult↗
PubMed1992

[Acute fatty liver of pregnancy--differential diagnosis and supportive therapy].

A case of clinically diagnosed acute fatty liver of pregnancy (AFLP) is reported. Hypoglycemia and coagulopathy were predominant in the clinical course. Serial studies on blood chemistry, especially blood glucose and coagulation parameters, in association with virus serology and ultrasound, can rule out common causes of jaundice in pregnancy. This contributes to reliability of the clinical diagnosis of AFLP in the absence of liver biopsy, and ensures adequate management of the patient.

Acute Disease↗
PubMed1992

Enteric Clostridium perfringens infection associated with parvoviral enteritis in dogs: 74 cases (1987-1990).

Parvovirus infection was confirmed by fluorescent antibody staining of or viral isolation from specimens of small intestine in 181 (17%) of 1,110 dogs necropsied between July 1, 1987 and Dec 31, 1990. Clostridium perfringens was isolated from 74 (69%) of 108 dogs with parvovirus infection from which specimens of jejunum also had been obtained for culture of anaerobic bacteria. Gram-positive bacilli in association with focal to diffuse necrosis of the superficial portions of the villi were observed in histologic sections of specimens of small intestine from 56 (98%) of 57 dogs from which parvovirus and C perfringens had been identified. These findings indicate that C perfringens frequently proliferates in dogs with parvovirus infection.

Animals↗
PubMed1992

Mechanism of chlorpromazine binding by gram-positive and gram-negative bacteria.

Chlorpromazine forms charge-transfer complexes with xanthene dyes in bacteria. These complexes permit the differentiation of Gram-positive and Gram-negative bacteria in both light and polarization microscopy. The birefringence induced by the charge-transfer complex might explain the molecular basis of bacterial staining. The charge-transfer complexes formed between chlorpromazine and xanthene dyes accumulate in the bacterial cell, mainly inside the bacterial cell wall. The complexes give the cells a color, which depends on the chemical composition of the staining structure, and in particular the polysaccharides of the cell wall in bacteria. Metachromatic granules were seen inside Gram-positive bacteria after chlorpromazine and rose bengal staining. Although the nature of these granules remains unclear, this type of binding may have a role in the inhibition of biochemical processes in the bacterial cells.

Binding Sites↗